Localized Pleural Mesothelioma: Investigation Of Its Characteristics And Histogenesis By The Method Of Tissue Culture

Our plain-English summary of Localized Pleural Mesothelioma: Investigation Of Its Characteristics And Histogenesis By The Method Of Tissue Culture, by A.P. Stout, M.R. Murray (1942).

The study

• Authors: A.P. Stout, M.R. Murray
• Published: Archives Of Pathology 34:951-964, December (1942)
• Type of article: Journal article
• Our copy: from Johns-Manville's own medical library, J-M no. 002203. The article is still under copyright, so we describe it here rather than post it.

In plain English

This 1942 article reported a single case together with a tissue culture study. It did not mention asbestos or any occupational exposure. The patient, a woman aged 43, had her left lung removed in October 1939. The tumor measured 10.5 by 8 by 7 cm and was attached to the pleura of the lower lobe of the left lung. Under the microscope it consisted of spindle-shaped cells with many blood vessels. Pieces of the tumor and of a metastasis in the lung were grown in the laboratory for 83 days. The cells grew as flat sheets with no fibroblast-type growth. The authors found them hard to distinguish from cultures of normal pleura, pericardium and mediastinum from young rats. She died twenty-six months after the operation. The authors concluded it was highly probable that the tumor was a primary tumor of the pleural mesothelium. Dr. A. M. Pappenheimer, who studied the case at autopsy, disagreed and leaned toward leiomyosarcoma spreading from uterine tumors. The authors kept their interpretation.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Case report of one patient, combined with a tissue culture study of the tumor and a review of earlier theories about pleural tumors
• Who was studied: One woman aged 43 with a cough of about two years. She had a total left pneumonectomy on October 11, 1939, and died December 12, 1941. The study was done at the Surgical Pathology Laboratory, College of Physicians and Surgeons, Columbia University, New York.
• Exposure: Not reported. The article does not mention asbestos, any fiber type or any occupational exposure.
• Main results:
  • The patient's tumor measured 10.5 by 8 by 7 cm and was attached to the pleura of the lower lobe of the left lung. A separate tumor nodule 35 mm in diameter was in the same lobe.
  • Under the microscope, the typical tumor cell was medium-sized and spindle-shaped (fusiform). Many vascular slits and tubes were present throughout.
  • Portions of the primary tumor and of the lung metastasis were grown in tissue culture for 83 days.
  • The fixed cells in the cultures grew as cords and membranes of broad, flattened cells. No fibroblastic outgrowth was ever obtained, so the authors excluded a fibroblastic origin.
  • The authors' own cultures of normal pleura, pericardium and mediastinum from young rats, and published images of normal mesothelium grown in culture, could hardly be distinguished from the tumor cultures.
  • The patient died twenty-six months after the operation. At autopsy there was a small metastasis in the head of the pancreas and another in the right ovary.
  • Dr. A. M. Pappenheimer, who studied the case at autopsy, disagreed with the authors. The diagnosis Pappenheimer favored was leiomyosarcoma, probably spreading from one of the uterine tumors. The authors reconsidered and kept their original interpretation.
• The authors' conclusion: The authors concluded that, combining the tissue sections with the tissue cultures, it seemed highly probable that the tumor was a primary tumor of the pleural mesothelium.
• Limitations the authors state:
  • Examining the tumor under the microscope alone did not allow an exact diagnosis.
  • Silver staining methods could not then be applied to the cultures, so it is unknown whether the tumor kept producing reticulin in culture.
  • From the tissue cultures alone, an origin from bronchial tissue could not be excluded.
  • The authors found no earlier account of tumors of the serous membranes studied in culture to compare with.
  • The authors acknowledged conflicting evidence about what serosal mesothelium cells are capable of forming.

Topics

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Occupational Exposure, Pleura, Spindle Cell, Metastasis, Fibroblast, Pericardium, Mediastinum.

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